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Chronic rhinosinusitis with nasal polyps in the elderly: Assessing current evidence
Allergy and Asthma Proceedings
|December 28, 2017
Summary
Chronic rhinosinusitis with nasal polyps (CRSwNP) in elderly patients can be safely managed with endoscopic sinus surgery (ESS). Caution is advised with prolonged systemic steroids, and recurrence rates after ESS may be lower in older adults.
Area of Science:
- Otolaryngology
- Geriatric Medicine
- Immunology
Background:
- Chronic rhinosinusitis (CRS) affects 4.7% of individuals over 60, making it a common condition in the elderly.
- Limited research exists on the specific characteristics of CRS with nasal polyps (CRSwNP) in older populations.
Purpose of the Study:
- To investigate the role of endotyping CRSwNP for tailored medical approaches in elderly patients.
- To critically discuss the pathophysiologic, clinical, and prognostic features of CRSwNP in geriatric patients.
Main Methods:
- Systematic review of data predominantly from the past 5 years.
- Analysis of existing literature on CRSwNP in elderly patients.
Main Results:
- Elderly patients with CRSwNP can undergo endoscopic sinus surgery (ESS) safely, similar to younger adults.
- Prolonged systemic steroid use requires caution in the elderly due to adverse effects.
- CRSwNP recurrence rates after ESS appear lower in the elderly compared to younger patients.
- Eosinophilic CRSwNP or high blood eosinophil counts were not significantly linked to higher recurrence in the elderly.
Conclusions:
- Further research is needed to investigate CRSwNP endotypes in large geriatric cohorts using biomarker assays.
- Identifying distinct endotypes will enable tailored diagnostic, therapeutic, and follow-up strategies for elderly CRSwNP patients.
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